TY - JOUR
T1 - Prospective characterisation of SARS-CoV-2 infections among children presenting to tertiary paediatric hospitals across Australia in 2020
T2 - A national cohort study
AU - Wurzel, Danielle
AU - McMinn, Alissa
AU - Hoq, Monsurul
AU - Blyth, Christopher C.
AU - Burgner, David
AU - Tosif, Shidan
AU - Buttery, Jim
AU - Carr, Jeremy
AU - Clark, Julia E.
AU - Cheng, Allen C.
AU - Dinsmore, Nicole
AU - Francis, Joshua Reginald
AU - Kynaston, Anne
AU - Lucas, Ryan
AU - Marshall, Helen
AU - McMullan, Brendan
AU - Singh-Grewal, Davinder
AU - Wood, Nicholas
AU - Macartney, Kristine
AU - Britton, Phil N.
AU - Crawford, Nigel W.
N1 - Funding Information:
Funding This study was supported by the Australian Commonwealth Department of Health (surveillance contract to the Paediatric Active Enhanced Disease Surveillance (PAEDS) Network, Reference ID: PH18/9934) and New South Wales Department of Health (grant no.: not applicable); Influenza Complications Alert Network Surveillance System (FluCAN), Murdoch Children’s Research Institute, Centers of Excellence in Influenza Research and Surveillance-National Institute of Health, Cross-Center Southern Hemisphere Project (grant no.: not applicable) and Sentinel Travelers and Research Preparedness Platform for Emerging Infectious Disease (SETREP-ID) project (grant no.: not applicable). CCB is supported by an NHMRC Investigator grant (APP1173163). DB is supported by a National Health and Medical Research Council (Australia) Investigator Grant (1175744). CCB is supported by an NHMRC Investigator grant (APP1173163). PNB is supported by an NHMRC Early Career Fellowship (APP1145817). Research at the Murdoch Children’s Research Institute is supported by the Victorian Government’s Operational Infrastructure Programme.
Publisher Copyright:
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/11/8
Y1 - 2021/11/8
N2 - Objective To present Australia-wide data on paediatric COVID-19 and multisystem inflammatory syndromes to inform health service provision and vaccination prioritisation.Design Prospective, multicentre cohort study.Setting Eight tertiary paediatric hospitals across six Australian states and territories in an established research surveillance network - Paediatric Active Enhanced Disease (PAEDS). Participants All children aged <19 years with SARS-CoV-2 infection including COVID-19, Paediatric Inflammatory Multisystem Syndrome Temporally Associated with SARS-CoV-2 (PIMS-TS) and Kawasaki-like disease TS infection (KD-TS) treated at a PAEDS site from 24 March 2020 to 31 December 2020. Intervention Laboratory-confirmed SARS-CoV-2 infection. Main outcome Incidence of severe disease among children with COVID-19, PIMS-TS and KD-TS. We also compared KD epidemiology before and during the COVID-19 pandemic.Results Among 386 children with SARS-CoV-2 infection, 381 (98.7%) had COVID-19 (median 6.3 years (IQR 2.1-12.8),53.3% male) and 5 (1.3%) had multisystem inflammatory syndromes (PIMS-TS, n=4; KD-TS, n=1) (median 7.9 years (IQR 7.8-9.8)). Most children with COVID-19 (n=278; 73%) were Australian-born from jurisdictions with highest community transmission. Comorbidities were present in 72 (18.9%); cardiac and respiratory comorbidities were most common (n=32/72;44%). 37 (9.7%) children with COVID-19 were hospitalised, and two (0.5%) required intensive care. Postinfective inflammatory syndromes (PIMS-TS/KD-TS) were uncommon (n=5; 1.3%), all were hospitalised and three (3/5; 60%) required intensive care management. All children recovered and there were no deaths. KD incidence remained stable during the pandemic compared with prepandemic. Conclusions Most children with COVID-19 had mild disease. Severe disease was less frequent than reported in high prevalence settings. Preventative strategies, such as vaccination, including children and adolescents, could reduce both the acute and postinfective manifestations of the disease.
AB - Objective To present Australia-wide data on paediatric COVID-19 and multisystem inflammatory syndromes to inform health service provision and vaccination prioritisation.Design Prospective, multicentre cohort study.Setting Eight tertiary paediatric hospitals across six Australian states and territories in an established research surveillance network - Paediatric Active Enhanced Disease (PAEDS). Participants All children aged <19 years with SARS-CoV-2 infection including COVID-19, Paediatric Inflammatory Multisystem Syndrome Temporally Associated with SARS-CoV-2 (PIMS-TS) and Kawasaki-like disease TS infection (KD-TS) treated at a PAEDS site from 24 March 2020 to 31 December 2020. Intervention Laboratory-confirmed SARS-CoV-2 infection. Main outcome Incidence of severe disease among children with COVID-19, PIMS-TS and KD-TS. We also compared KD epidemiology before and during the COVID-19 pandemic.Results Among 386 children with SARS-CoV-2 infection, 381 (98.7%) had COVID-19 (median 6.3 years (IQR 2.1-12.8),53.3% male) and 5 (1.3%) had multisystem inflammatory syndromes (PIMS-TS, n=4; KD-TS, n=1) (median 7.9 years (IQR 7.8-9.8)). Most children with COVID-19 (n=278; 73%) were Australian-born from jurisdictions with highest community transmission. Comorbidities were present in 72 (18.9%); cardiac and respiratory comorbidities were most common (n=32/72;44%). 37 (9.7%) children with COVID-19 were hospitalised, and two (0.5%) required intensive care. Postinfective inflammatory syndromes (PIMS-TS/KD-TS) were uncommon (n=5; 1.3%), all were hospitalised and three (3/5; 60%) required intensive care management. All children recovered and there were no deaths. KD incidence remained stable during the pandemic compared with prepandemic. Conclusions Most children with COVID-19 had mild disease. Severe disease was less frequent than reported in high prevalence settings. Preventative strategies, such as vaccination, including children and adolescents, could reduce both the acute and postinfective manifestations of the disease.
KW - COVID-19
KW - epidemiology
KW - paediatric infectious disease & immunisation
KW - paediatrics
KW - public health
KW - virology
UR - http://www.scopus.com/inward/record.url?scp=85119437986&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2021-054510
DO - 10.1136/bmjopen-2021-054510
M3 - Article
C2 - 34750151
AN - SCOPUS:85119437986
VL - 11
JO - BMJ Open
JF - BMJ Open
SN - 2044-6055
IS - 11
M1 - e054510
ER -